ACQUIRED BRAIN INJURY

Malcolm McKenzie, M.Sc.AdminPatient Care Manager

Neurology Rehabilitation ProgramRiverview Health Centre

June 09th, 2011

“He’s ready for what……………discharge”??

INTRODUCTIONACQUIRED BRAIN INJURY

•What is it?

•An Analogy

YELLOW BLUE ORANGE

BLACK RED GREEN

PURPLE YELLOW RED

ORANGE GREEN BLUE

LOOK AT THE CHART AND SAY THE COLOR NOT THE WORD.

• Role of rehabilitation teams in helping brain injury survivors through difficult crises in reaching their highest functional level of independence.

• May be short duration or a continuous lifelong process

• Specific goals – dependent on the survivor’s individual capacity

GOAL OF REHABILITATION

Specific Goals continued

• To promote adaptation and adjustment of the survivor and family to a changed life

• To emphasize abilities to promote adaptation or adjustment

• To return to successful function within the community.

What are we dealing with?

•Individual personalities and support systems

•Involves a problem-solving approach that is based on the process of assessment, planning, interventions and evaluation.

•Survivors / families better informed today and they often challenge staff/caregivers.

PROCESS

GOOD POTENTIAL POOR POTENTIAL• Strong willed and determined • Gives up easily

• Under 21 years of age • Over 40 years of age

• Similar pre-injury/post-injury vocational abilities

• Wide gap in pre/post injury vocational abilities

• No previous history of brain insult

• History of previous brain insult

• Good stress management skills

• Poor stress management skills

• Good social relationships

• Good character and self-control

• Intact family

• Good relationship with family

• High I.Q.

• No history of drug / alcohol abuse

PREDICTORS OF FUNCTIONAL RECOVERY

REHABILITATION POTENTIAL

• Team approach is the foundation of rehabilitation care.

• Treat the multiple needs of the ‘whole’ person.

• The Interdisciplinary team (IDT) has interactive partnerships.

• The patient is the family.

• Family support is key.

TEAM INVOLVEMENT

• Emotional status

• Cultural barriers

• Knowledge

• Potential care-giver stress / inability to cope

• Infantalization of survivor

FAMILY ASSESSMENT / CHALLENGES

• Physical Functioning• Cognitive Functioning• Emotional Functioning• Social and Community Functioning

SERVICE DELIVERY MODEL

INDIVIDUAL TREATMENT INTERVENTION

• Values and Beliefs• Functional Levels• Continuum of Care

• Dealing with week-end Leaves of Absence

• Telerehabilitation may be required

• Re-integration versus Re-entry• Vocational Evaluation• Work Adjustment• Retraining• Job placement

READINESS FOR COMMUNITY

WHAT’S NEXT??

• An overview of rehabilitation – philosophy, values, goals and models of care

• Emphasis on teams and family assessment

• Importance of family involvement

• Continuum of care

CONCLUSION

QUESTIONS…